Practice Management Alert

Question: A physician in my office wants to bill services under another physician's tax ID within the practice, but I've been taught not to. What should I do? Oregon Subscriber Answer: This may be rule #1 for all billers: When a physician provides services, only bill the services to the physician who performed the work. The name and national provider identifier (NPI) on the CMS-1500 form must be the name and number of the provider who actually performed the service. What about "incident-to" billing? One physician cannot provide services incident to another physician. "Incident-to" billing only applies to nonphysician practitioners (NPPs), and even then you must follow a number of guidelines to the letter. In addition, "incident-to" does not apply in hospitals, skilled nursing facilities, or homes. The rules are clear: You need only read the back of the CMS-1500 form to find this guidance in writing: "Any person who [...]